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PERMITTEE NAME/ADDRESS;Include F'aciliq NamdLucalion if Different) NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />NAME DISCHARGE MONITORING REPORT (DMR) <br />ADDRESS t a1= <br />, 0 y 677 PERMIT NUMBER DISCHARGE NUMBER <br />FACILITY MONITORING PERIOD <br />'MINE C{2i~ii YEAR MID DAY YEAR MO DAY <br />LOCATION FROM TO <br />Form Approved <br />OMB No- 2040-000- <br />I?i <br />(SULK •. <br />r - EI°• , <br />LtSGH T Ll -{ t.1B/GRASSY t-;REL?-. <br />NOTE: Read Instructions before completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. FREOUENCY <br />OF SAMPLE <br /> EX TYPE <br /> ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE f ) U ?/ <br /> <br />MEASUREMENT J <br /> <br />PERMIT L? <br /> REQUIREMENT <br /> SAMPLE <br />T <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT _ n . <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> <br />REQUIREMENT r <br /> SAMPLE ! L <br /> MEASUREMENT <br />PERMIT ` <br />REQUIREMENT <br />NAMEMTLE P INCIPAL XECUTIVE OFFICER 1 certify under penally glow that this document and all attachment. were TELEPHONE DATE <br />prepared under ms direction or wwr%i•ion In accordance with a system designed - <br />to Aasure that qualified pe-nnel properly gather and esaluale the information <br />h <br />h <br />t I <br />i <br />e system, <br />submitted. Based on my inquiry of the penon or penons w <br />o manage t <br />s <br />Hydrolog <br />' <br />.7 -, 9 or those penons directly responsible for galhrring the information, the information <br />9'0; 2 . ~-?4"^J' GrJ wbmilled i%, to the hest or in% knowledge and belief, true. accurate, and complete. <br />SIGNA RE OF PRINCIPAL EXECUTIVE _ <br /> I am aware that them ere significant penalties for submitting false information, <br />wi <br />st <br />l <br />i <br />t f <br />k <br />ti <br />? <br />' OFICER OR AUTHORIZED AGENT AREA NUMBER YEAR MO DAY <br />TYPED OR PRINTED sonmen <br />a <br />ons. <br />ti sf fine and impr <br />or <br />no <br />ng <br />o <br />Including the pn <br />d ib <br />? <br />COMMENTS AND EXYLANAIIUIV OF Ar4T vIULAIIUna (Pfefer-enGtf eu nttn(onlnerns frofet <br />TRrI) TO a. E'1l )EIT ^ REIAcONAIiI_.F_ POTEts!T I AL ANALYSIS HE <br />PAGE OF <br />EPA Form 3320-1 (Rev. 3199) Previous editions may be used. This is a 4Part form.